New Yorker Days 2013

Clearing out a basket, I found New Yorkers from 2006. This is definitely out of control. So I have entered New Yorker days–reading voraciously through issue after issue. (Only read three articles from some of the those old issues–anyone for an analysis of who solved the Poincarre conjecture?!) But I really liked a passage from one of my favorite writers, Atul Gawande, in an article about why some innovations spread quickly and others so slowly. He begins by comparing the lightning fast adoption of anesthesia around the world in 1846 as opposed to the decades and decades it took for the concept of antiseptic measures to catch on in surgical practice after their introduction in the 1860s. Gawande investigates what instigates such changes as part of his work with the BetterBirth Project, a group focused on infant and maternal mortality during childbirth or shortly thereafter. The group is sending trained workers out to teach better protocols–“a checklist of essential practices” including handwashing, taking infant temperatures, swaddling infants against their mothers’ skin, etc.–to the healthcare workers who deliver the babies.

Gawande explains why the group has chosen this hands-on, person-to-person approach:

“In the era of the iPhone, Facebook, and Twitter, we’ve become enamored of ideas that spread as effortlessly as ether. We want frictionless, “turnkey” solutions to the major difficulties of the world—hunger, disease, poverty. We prefer instructional videos to teachers, drones to troops, incentives to institutions. People and institutions can feel messy and anachronistic. They introduce, as the engineers put it, uncontrolled variability.

But technology and incentive programs are not enough. “Diffusion is essentially a social process through which people talking to people spread an innovation,” wrote Everett Rogers, the great scholar of how new ideas are communicated and spread. Mass media can introduce a new idea to people. But, Rogers showed, people follow the lead of other people they know and trust when they decide whether to take it up. Every change requires effort, and the decision to make that effort is a social process. [emphasis added]

This is something that salespeople understand well. I once asked a pharmaceutical rep how he persuaded doctors—who are notoriously stubborn—to adopt a new medicine. Evidence is not remotely enough, he said, however strong a case you may have. You must also apply “the rule of seven touches.” Personally “touch” the doctors seven times, and they will come to know you; if they know you, they might trust you; and, if they trust you, they will change. That’s why he stocked doctors’ closets with free drug samples in person. Then he could poke his head around the corner and ask, “So how did your daughter Debbie’s soccer game go?” Eventually, this can become “Have you seen this study on our new drug? How about giving it a try?” As the rep had recognized, human interaction is the key force in overcoming resistance and speeding change. (41-42, New Yorker, 7-29-2-13)

As with many fields, teaching looks to new technologies–computers, iPads, internet, social media, etc.–for ways to enhance, improve education, to reach the students. Online education gets touted almost daily, and yet, Gawande rightly points out a secret at the heart of good teaching of any kind–the idea of human contact. Students respond to seeing their teacher each day, to learning to trust and like him/her enough to follow the teacher into the arena of knowledge, even to trust that critiques further their journey. Just as the BetterBirth worker saw one of the birth attendants she worked with change over time from initially taking offense at the teachings as a form of criticism to coming to enjoy the worker’s visits and to trust her because “she smiled a lot.” People talking to people.


A column of balconies–no one to talk to


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